Schaefer pushes for name reporting of HIV patients STATE HOUSE REPORT

The 2-year-old struggle over how to identify Marylanders who test positive for the AIDS virus is expected to resume today at a legislative hearing in Annapolis.

The 1992 General Assembly ordered development of a code system, but the Schaefer administration still dislikes that method.

"It is more cumbersome and costly and more prone to error than simple name reporting," Bonnie Kirkland, the governor's chief legislative officer, said this week.

Both sides agree that the state needs to track the spread of HIV while protecting the privacy of those infected with the virus that causes acquired immune deficiency syndrome.

One method of reporting is to have physicians use a code, called a "unique identifier," instead of the patient's name.

Two years ago, the General Assembly passed a compromise bill ordering the state health department to have a code system operating by Oct. 1, 1993. The department missed the deadline but says it expects to comply by spring.

According to the Maryland AIDS Administration, the state already has accepted federal funds -- $211,000 annually for three years -- to evaluate the effectiveness of the code system. The money comes from the Centers for Disease Control and Prevention.

However, the Schaefer administration has said all along that reporting by name is preferable. "It is still the administration's and the health department's contention that a unique identifier system doesn't work as well," said Ms. Kirkland.

Under an administration bill due for a hearing before the House Environmental Matters Committee today, the names of Marylanders who have the human immunodeficiency virus would be reported to the state health department, which would keep them confidential.

In 1992 and 1993, the legislature rejected this method of HIV reporting. But the 1994 Schaefer bill would exempt certain test locations from providing names, said Ms. Kirkland.

In all states, people diagnosed with full-blown AIDS are reported by name to state health departments.

But there is a fear that a similar system for HIV could accelerate the spread of the epidemic because many would shun testing.

"People with the infection don't want to be on lists," said Dr. John Bartlett, director of the infectious disease division of Johns Hopkins University Medical Systems.

The code for the unique identifier consists of the last four digits of a person's Social Security number, plus birth date and gender.

"Names do not impart any more needed information than a unique identifier, but a name has the potential for a breach of confidentiality," said Dr. Liza Solomon, an epidemiologist at the Johns Hopkins University School of Public Health.

She is bothered by the state health department's slowness to implement the code system.

"One really does have to question if they've been dragging their feet so that they can come to the legislature without a system in place and use that as an argument for names reporting," said Dr. Solomon.